International SportMed Journal - Volume 5, Issue 2, 2004
Volume 5, Issue 2, 2004
Source: International SportMed Journal 5, pp 67 –83 (2004)More Less
Objectives : This review presents an overview of the biological processes involved in repair and remodelling of skeletal muscle after exercise-induced damage. The concept that repeated bouts of exercise-induced muscle damage, over a number of years, places excessive regenerative demands on the skeletal muscle is also introduced and discussed.
Data sources : A thorough search of MEDLINE was conducted using the following search terms : exercise-induced muscle damage; skeletal muscle regeneration; skeletal muscle remodelling; satellite cells; satellite cell activation AND exercise-induced muscle damage; skeletal muscle adaptation AND exercise-induced muscle damage.
Study section : All the information in this review is taken from original research as well as review articles dealing with this topic.
Conclusions : Although skeletal muscle has a remarkable capacity to repair and adapt to exercise-induced muscle damage, there is a limit to this capacity for remodelling. The precise impact of repeated bouts of muscle damage and repair, over a number of years, on the remodelling capacity of skeletal muscle is not known. However, there is evidence to suggest that athletes who expose their muscles to rigorous training and racing regimes may exceed the muscles finite capacity for repair and adaptation.
Source: International SportMed Journal 5, pp 84 –97 (2004)More Less
Objective : The primary objective of this review article is to explore strategies to prevent delayed onset muscle soreness (DOMS) after strenuous exercise.
Data sources : MEDLINE and PubMed databases were searched using combinations of the terms delayed onset muscle soreness, muscle pain, eccentric , lengthening, downhill, muscle damage, repeated bout, force, torque, velocity, performance, activation, function, proprioception, kinesthetic. In addition, the reference sections of selected articles were searched.
Study selection : 115 studies were selected based on quality, relevance and importance to the primary objective of the review.
Data extraction : Results from studies utilised in this review were critically interpreted and summarised by the authors (Note : No meta-analytic procedures were used).
Data synthesis : DOMS is a result of muscle damage that occurs after strenuous exercise. Mechanical damage to muscle leads to discomfort, reductions in muscle force and range of motion, swelling, and elevated muscle protein levels in the blood. In addition, DOMS may affect athletic performance due to its impact on strength and range of motion, proprioception, and gait biomechanics.
Conclusions : There is a paucity of data on the effects of DOMS on athletic performance and strategies of prevention. Prevention of DOMS may be achieved by adapting the muscle to eccentric stress prior to competitive performance. Future research to establish eccentric exercise prescription for athletes and strategies to maximise its beneficial effects are warranted. This knowledge may enhance athletic performance by incorporating proper mode and timing of resistance training to prevent the potential performance-inhibiting effects of DOMS.
Source: International SportMed Journal 5, pp 98 –118 (2004)More Less
Objective : The effectiveness of treatment strategies for delayed onset muscle soreness (DOMS) is examined.
Data sources : Literature was located using PubMed, SPORTDiscus, ProQuest 5000 International, MEDLINE, and manual searches of publications since 1948. Keywords included in the searches were delayed onset muscle soreness, muscle injury, muscle strain, treatment, and eccentric exercise.
Data section and extraction : A total of 163 papers were reviewed. The criteria for paper inclusion were : proposed treatment of DOMS addressed; normal, healthy subjects were used; age, sex, fitness differences were not excluding factors; DOMS may have been discussed in relation to other forms of muscle injury; reviews of previous research were included.
Data synthesis : A number of treatment strategies have been introduced to help alleviate the severity of DOMS and to restore the maximal function of the muscles as rapidly as possible. Post-DOMS exercise seems to be an effective means of alleviating DOMS pain; however, the analgesic effect is temporary. Non-steroidal anti-inflammatory drugs have demonstrated dosage-dependent effects that may be influenced by the time of administration. Compression, magnetic exposure and hot packs have shown moderate success in treating DOMS symptoms. Massage has shown varying results attributed to the time of massage application and the type of massage technique used. Homeopathy, ultrasound, electrical current techniques, cryotherapy, hyperbaric oxygen therapy, stretching, acupuncture have demonstrated limited or no effects on the alleviation of DOMS symptoms.
Conclusions : Treatment attempts for DOMS are plentiful; however, there has been only limited success reported in decreasing the perception of soreness. There has also been limited success in reducing swelling, or promoting recovery of force production after muscle damage. Athletes should be encouraged to reduce the intensity and duration of exercise for one to two days following intense DOMS-inducing exercise. Exercises targeting less affected body parts should be encouraged to allow the most affected muscle groups to recover. Prevention is still the best "cure".
The role of massage in the treatment of delayed onset muscle soreness : a brief review : review articleSource: International SportMed Journal 5, pp 110 –119 (2004)More Less
Objective : The literature on the physiological and psychological effects of massage as it relates to delayed onset muscle soreness (DOMS) was reviewed.
Data sources : The electronic databases MEDLINE and SPORTDiscus were searched from their inception until January 2004 with the keywords : massage, muscle, and soreness.
Study section : The relevant articles were retrieved, respective bibliographies for additional resources reviewed, and manuscripts that were in English, peer reviewed, and whose research design included a control group and classical massage techniques were used.
Data extraction : Extracted data addressed massage's putative ability to alter circulation, inflammation, muscle function, and psychological well-being after exercised induced muscle damage. Eight studies met inclusion criteria; their data were analysed qualitatively.
Data synthesis : Classical massage reduced muscle soreness across approximately 75% of the reviewed articles, many of which found this reduction despite low statistical power, consequent to small sample sizes. Massage did not, however, appear to alter muscle function and inflammation, the latter measured by changes in the circulating neutrophil count or leg volumes. The effects of massage on circulatory and psychological variables have been studied less frequently; hence, it is difficult to draw meaningful conclusions.
Conclusions : Despite nearly 75% of the data showing reduced muscle soreness, only one study found that massage improved muscle function, and this improvement did not occur in all the administered functional tests. Future research is needed to better understand the functional significance of reduced muscle soreness. Additionally, to further assess the effects of massage on DOMS, researchers should measure changes in endorphins, stress hormones, mood states, and multi-dimensional aspects of pain.
Author Angela Baldwin LanierSource: International SportMed Journal 5, pp 129 –140 (2004)More Less
Non-steroidal anti-inflammatory drugs (NSAIDs) are used by athletes of all ages and at all levels of competition, to treat muscle injuries and soreness from participation in sport. While studies suggest that NSAIDs may be beneficial for attenuating soreness and muscle dysfunction following certain types of eccentric exercise in some individuals, it is not conclusive because of gross inconsistencies in the literature. These inconsistencies exist because of differences in study designs, use of different drugs, dosages, and injury models. In addition to this review challenge, there are other concerns related to the safety of NSAID use in sport. Some findings have suggested that NSAIDs may actually hinder the healing process and may be counterproductive for long-term muscle adaptation. For athletes, proper healing and adaptation to exercise is crucial for performance and injury prevention. Another concern is that chronic NSAIDs use has been related to certain adverse effects, i.e. increased occurrence of gastrointestinal and kidney complications. More well-designed, randomised trials are needed to determine if NSAIDs are beneficial and safe for short-term and long-term muscle adaptation in sport.
Source: International SportMed Journal 5, pp 141 –146 (2004)More Less
Electrotherapy is a form of rehabilitative treatment where electrical stimulation is used as a form of therapy. Examples of electrotherapy date back to 2500 BC with stone carvings in tombs in ancient Egypt showing patients being treated with catfish capable of producing an electrical charge. Microcurrent therapy, also called "microcurrent electrical neuromuscular stimulation" (MENS) is one of several forms of electrotherapy. A characteristic of microcurrent therapy is that the stimulating current is less than 600 µA and does not cause a contraction in skeletal muscle. Microcurrent therapy presumes the principle that injured tissue produces abnormal electrical potentials, termed "injury potentials" which are associated with a disturbance in homeostasis. In accordance with this theory, microcurrent therapy re-establishes "normal" electrical balance in the tissue and minimizes this disruption, resulting in a more rapid regeneration and return of normal function. Studies have investigated the efficacy of microcurrent therapy treatment on wound healing, and have generally shown that treatment can accelerate the healing process. However, a weakness of many of these studies has been the poor explanation of the treatment modalities, making comparisons between studies difficult. The effect of microcurrent therapy on soft tissue injuries is less well defined. A double-blind placebo controlled clinical trial investigating the efficacy of microcurrent therapy on soft tissue injury showed that treatment of the elbow flexor muscles immediately after the injury, and for four days thereafter reduced the severity of the symptoms of exercise-induced muscle damage. The mechanism explaining these effects is not well understood. Further laboratory and clinical trials are needed to explain the mechanism of action and the evidenced-based prescription of microcurrent therapy for tissue injury.
The role of non-steroidal anti-inflammatory drugs for the treatment of delayed onset muscle soreness in sport : review articleSource: International SportMed Journal 5, pp 147 –154 (2004)More Less
Objective : To investigate the efficacy of non-steroidal anti-inflammatory drugs for the treatment of delayed onset muscle soreness.
Data sources : PubMed and SPORTDiscus databases were searched from January 12-30, 2004 for the following terms: delayed onset muscle soreness, DOMS, exercise induced/associated muscle damage/soreness, contraction induced muscle damage/soreness, muscle injury, muscle soreness, non-steroidal anti-inflammatory drugs, aspirin, diclofenac, flurbiprofen, ibuprofen, ketoprofen, and naproxen.
Study section : Inclusion criteria were use of human subjects and placebo-controlled design.
Data extraction : Information relevant to specific drug studied, dosing, method of inducing DOMS, measurements used, and outcome were used.
Data synthesis : Studies with primary findings supporting and refuting the use of NSAIDs for the treatment of DOMS are individually discussed.
Conclusions : Due to potential adverse effects and inconclusive evidence, it is our opinion that the routine recommendation of NSAIDs for the treatment of DOMS is not warranted.
Metabolic responses to multiple bouts of supra-maximal exercise in trained and untrained subjects : research articleSource: International SportMed Journal 5, pp 155 –164 (2004)More Less
Background : Performance and metabolic pathways used in submaximal exercise have been well examined, but not above VO2max.
Research question : To examine the pattern of energy use during supra-VO2maximal exercise, the metabolic responses of both trained and untrained subjects to repeated bouts of intense, constant power exercise, which was designed to deplete muscle glycogen, were evaluated.
Methods : Sixteen males with similar genetic aerobic capacity were studied: active but untrained (AUT), and exercise trained (TR). Subjects ran to exhaustion at 125% VO2max for 25 bouts (20 min. rest periods, water but no carbohydrate supplementation).
Results : The results are presented as mean ± SD. Total exercise time was significantly greater in TR (42.75 ± 3.85 min) than AUT (33.10 ± 6.95 min). VO2remained constant at 95% of maximum for 10 bouts in AUT and for 20 bouts in TR, after which VO2 dropped to 60-65% of maximum in AUT and to 85-90% of maximum in TR. During bouts 11-25, TR had significantly greater peak lactates (6.91±0.9 vs. 2.66±0.5 mM), greater VE/VO2 ratios (31 ± 2 vs. 25 ± 9) and greater rates of lactate accumulation (4.90±0.74 vs. 3.09±0.68 Mm.min-1) than AUT.
Conclusions : TR had significant glycolysis during all 25 exercise bouts, whereas AUT became glycogen-depleted. Trained subjects apparently spared glycogen during supra-VO2maximal exercise presumably by oxidising more fat (in slow twitch fibres). Thus athletes who participate in anaerobic events may benefit substantially from aerobic training, as well as anaerobic training.